Tolia V, Kuhns L, Kauffman R E
Department of Pediatrics, Children's Hospital of Michigan, Detroit.
Am J Gastroenterol. 1993 May;88(5):661-4.
Twenty-nine infants under 1 yr of age were studied by simultaneous esophageal pH monitoring and scintigraphy for evaluation of gastroesophageal reflux (GER). Scintigraphy and pH monitoring were performed for 120 min after infants ingested their usual volume of formula. The number of reflux episodes during six 20-min intervals, as determined by both tests, were recorded. Esophageal pH monitoring was continued for 18-24 h. Sixteen of 29 patients exhibited GER by pH monitoring during the 2-h study. Gastroesophageal reflux occurred in seven of 29 during the first hour and 13 of 29 during the second hour. The mean time of first reflux episode detected by pH monitoring following the feeding was 82.4 +/- 49.3 min. In comparison, 28 of 29 patients had GER by scintigraphy during the 2 h. All 28 exhibited GER during the first hour, whereas only 22 of 29 patients exhibited GER during the second hour. The mean time of first episode of reflux by scintigraphy was 3.1 +/- 2.7 min. Forty-five percent of all reflux episodes detected by scintigraphy occurred during the first 20 min and 80% were detected during the first hour. In contrast, only 17% of reflux episodes were seen by pH monitoring during the first 20 min and 35% during the first hour; 65% of reflux episodes detected by pH monitoring were during the second hour. There was no correlation between the total number of reflux episodes detected by scintigraphy and 2-h esophageal pH monitoring during the 2-h study period (r = 0.326; p > 0.1). Overall, to detect reflux, scintigraphy was a more sensitive method than esophageal pH monitoring under the conditions of this study. Scintigraphy selectively detected reflux during the first 60 min post-prandially whereas pH monitoring was more likely to detect reflux beyond the first postprandial hour. These observations help to explain the lack of correlation between the two tests.
对29名1岁以下婴儿进行了同步食管pH监测和闪烁扫描，以评估胃食管反流（GER）。在婴儿摄入其通常量的配方奶后，进行120分钟的闪烁扫描和pH监测。记录通过两种测试确定的六个20分钟间隔内的反流发作次数。食管pH监测持续18 - 24小时。29名患者中有16名在2小时研究期间通过pH监测显示有GER。29名患者中有7名在第一小时发生胃食管反流，29名中有13名在第二小时发生。喂食后通过pH监测检测到首次反流发作的平均时间为82.4±49.3分钟。相比之下，29名患者中有28名在2小时内通过闪烁扫描显示有GER。所有28名在第一小时均出现GER，而29名患者中只有22名在第二小时出现GER。通过闪烁扫描首次反流发作的平均时间为3.1±2.7分钟。闪烁扫描检测到的所有反流发作中有45%发生在最初20分钟内，80%在第一小时内检测到。相比之下，pH监测在最初20分钟内仅发现17%的反流发作，第一小时内为35%；pH监测检测到的反流发作中有65%发生在第二小时。在2小时研究期间，闪烁扫描检测到的反流发作总数与2小时食管pH监测之间无相关性（r = 0.326；p>0.1）。总体而言，在本研究条件下，闪烁扫描是比食管pH监测更敏感的检测反流的方法。闪烁扫描选择性地检测餐后最初60分钟内的反流，而pH监测更有可能检测到餐后第一小时之后的反流。这些观察结果有助于解释两种测试之间缺乏相关性的原因。
